How To Use CPT Code 26725

CPT 26725 describes the closed treatment of a phalangeal shaft fracture in the proximal or middle phalanx of a finger or thumb. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 26725?

CPT 26725 is used to describe the closed treatment of a phalangeal shaft fracture in the proximal or middle phalanx of a finger or thumb. This procedure involves the manipulation, or adjustment, of the fractured bone to realign it. The provider may also use skin or skeletal traction to reduce the fracture and stabilize it. After the manipulation and reduction, the patient’s finger is placed in a brace or splint for approximately four weeks to support proper healing.

2. Official Description

The official description of CPT code 26725 is: ‘Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb; with manipulation, with or without skin or skeletal traction, each.’

3. Procedure

1. The provider begins by appropriately prepping and anesthetizing the patient.
2. Next, the provider manipulates the fractured fragment by exerting a pushing or pulling force on the phalanx to realign the bones.
3. If necessary, the provider may apply skin or skeletal traction force using a pin, wire, screw, or clamp to further reduce and stabilize the fracture.
4. After the manipulation and reduction, the provider places the patient’s finger in a brace or splint to support proper healing.
5. The provider may also perform an X-ray examination of the finger or thumb bone to confirm the reduction of the fracture.

4. Qualifying circumstances

CPT 26725 is used for patients with a phalangeal shaft fracture in the proximal or middle phalanx of a finger or thumb. The procedure involves the manipulation and reduction of the fractured bone, with or without the use of skin or skeletal traction. The provider must ensure that the patient is appropriately prepped and anesthetized before performing the procedure.

5. When to use CPT code 26725

CPT code 26725 should be used when a provider performs the closed treatment of a phalangeal shaft fracture in the proximal or middle phalanx of a finger or thumb. This code is appropriate when the provider manipulates the fractured bone to realign it and may use skin or skeletal traction to further stabilize the fracture. It is important to note that CPT code 26725 should not be used if the provider does not perform manipulation or if they perform percutaneous skeletal fixation or open treatment with internal fixation implants.

6. Documentation requirements

To support a claim for CPT code 26725, the provider must document the following information:

• Patient’s diagnosis of a phalangeal shaft fracture in the proximal or middle phalanx of a finger or thumb
• Details of the manipulation and reduction performed
• Use of skin or skeletal traction, if applicable
• Placement of a brace or splint on the patient’s finger
• Confirmation of the reduction through an X-ray examination, if performed

7. Billing guidelines

When billing for CPT code 26725, ensure that the provider performs the closed treatment of a phalangeal shaft fracture in the proximal or middle phalanx of a finger or thumb. The procedure may involve manipulation and may or may not include skin or skeletal traction. It is important to note that CPT code 26725 should not be reported with other codes for different procedures. Additional tips for reporting CPT code 26725 include using code 26720 for closed treatment without manipulation and code 26727 for percutaneous skeletal fixation with manipulation.

8. Historical information

CPT code 26725 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A patient presents with a phalangeal shaft fracture in the proximal phalanx of their thumb. The provider performs closed treatment with manipulation, realigning the fractured bone and applying a thumb splint for support.
2. During a basketball game, a patient sustains a phalangeal shaft fracture in the middle phalanx of their index finger. The provider performs closed treatment with manipulation, reducing the fracture and placing the patient’s finger in a brace for healing.
3. A patient comes in with a phalangeal shaft fracture in the proximal phalanx of their ring finger. The provider performs closed treatment with manipulation, adjusting the fractured bone and applying a splint to support proper healing.
4. After a fall, a patient presents with a phalangeal shaft fracture in the middle phalanx of their little finger. The provider performs closed treatment with manipulation, realigning the fractured bone and placing the patient’s finger in a brace for stabilization.
5. A patient injures their thumb, resulting in a phalangeal shaft fracture in the proximal phalanx. The provider performs closed treatment with manipulation, reducing the fracture and applying a thumb splint for support during the healing process.
6. During a sports activity, a patient sustains a phalangeal shaft fracture in the middle phalanx of their middle finger. The provider performs closed treatment with manipulation, adjusting the fractured bone and placing the patient’s finger in a brace for proper healing.